Protein vs Creatine vs Omega-3: The Winner Is…

Creatine, protein, and omega-3s all have evidence behind them, but this network meta-analysis suggests each one may shine in a different lane.

Overview

• What did they test? The authors performed a systematic review and meta-analysis comparing protein, omega-3 and creatine supplementation in trained athletes or active, healthy, individuals. The main outcomes were muscle strength, endurance performance, and recovery.
• What did they find? Across 35 randomized controlled trials with 1,211 participants, creatine ranked highest for muscle strength, protein was best for endurance performance, and omega-3s were best for recovery outcomes. 
• What does it mean for you? Creatine is the most effective for strength, protein for endurance training, and omega-3s for recovery. However, the supplement comparisons were from indirect comparisons.

What’s the Problem?

Protein, creatine, and omega-3s are all evidence-based, and are mostly studied in isolation. Protein studies tend to focus on muscle mass and strength. A seminal study on protein intake found that supplementation modestly enhances resistance training–induced gains in fat-free mass and strength, but benefits appearing to plateau around ~1.6 g/kg/day, although the upper confidence interval extended to ~2.2 g/kg/day 1. More recent meta-analytic work found that higher daily protein intake produces small additional gains in lean body mass and lower-body strength during exercise, and others have found that protein’s effect on strength depends heavily on resistance training and appears to rise up to about 1.5 g/kg/day, with little additional benefit beyond that point 2 3. While less studied, protein supplementation can also improve endurance performance 4.

Creatine, as our readers know, has a very good evidence profile. A recent meta-analysis found that creatine combined with resistance training improves both upper- and lower-body strength, with effects appearing more consistent in males than females 5. Kazeminasab et al. reached a similar conclusion, finding that creatine improves strength in major lifts like the bench press and squat, while also improving muscular power 6. The body composition data also point in the same direction. Burke et al. found that creatine plus resistance training increases muscle hypertrophy 7. Where creatine is less impressive is endurance performance, but some have noted that it may be useful in endurance sports that include repeated sprints or other high-intensity efforts at the end of the event 8.

Omega-3 research is usually aimed more at recovery than performance. Xin and Eshaghi found that omega-3 supplementation reduced post-exercise creatine kinase (CK), lactate dehydrogenase, and myoglobin, suggesting a reduction of biomarkers of muscle damage 9. Others have also found that omega-3 supplementation reduced delayed-onset muscle soreness (DOMS) after eccentric exercise, but the effect was small enough that they questioned whether it was meaningful 10. More recently, Fernández-Lázaro et al. reviewed randomized trials and concluded that omega-3s may support post-exercise recovery 11.

Athletes and lifters often consume multiple supplements for different reasons, but they may have to choose one over another due to monetary or access limitations. That is where this meta-analysis can be useful, because it compared these supplements across different outcomes using direct and indirect evidence. 

Purpose

The purpose of this systematic review and network meta-analysis was to compare the effects of protein, creatine, and omega-3 supplementation on muscle strength, endurance performance, and recovery. The authors also wanted to rank each supplement by outcome, since most existing studies compare one supplement to a placebo rather than comparing supplements directly against one another. 

Hypothesis

The authors did not state a specific hypothesis.

What Did They Test and How?

Participants